Chapter Eight. Syndrome of food accumulation and formula composition
CHAPTER CONTENTS
CHAPTER OUTLINE
This chapter introduces the principles, methods and strategies for the composition of formulas that promote digestion and dissolve accumulated food. They are used to treat the syndrome of food accumulation.
Although food accumulation is not commonly seen nowadays in developed countries, food accumulation might still occur in certain situations:
• It may occur in infants, since their Spleen and Stomach are not fully developed and the parents may lack experience or knowledge of the best way to feed and nurse their child.
• It also happens among elderly people since their digestion is slower than before.
• It can arise in people with a weak constitution, patients who suffer from chronic diseases, people who have been eating under stress for a long period of time, and people who change their diet dramatically. Because their Spleen and Stomach are not strong, food can easily become stagnant in the Middle-Jiao.
• Acute cases can sometimes occur in the vacation period when the diet is changed significantly, or among people who overindulge in food.
Syndrome of food accumulation
Manifestations
Main symptoms
Fullness in the stomach, belching, nausea, vomiting with a foul smell, distending pain in the abdomen, constipation or diarrhea.
Secondary symptoms
Chronic indigestion, poor appetite, distension of abdomen, particularly after meals or after taking heavy, unfamiliar food, impairment of general condition and development in children.
Tongue
Normal tongue with a white or slightly yellow sticky coating.
Pulse
Slippery, forceful and rapid.
Associated disorders in western medicine
Acute or chronic diseases and disorders of the digestive system and the immune system, such as chronic gastric ulcer, duodenal ulcer, irritable bowel syndrome, food allergy and intolerance.
Analysis of the syndrome
Proper digestion depends on the cooperation of the Stomach and Spleen. In the Middle-Jiao, the Stomach-Qi moves downwards and the organ receives and ripens food; the Spleen-Qi moves upwards and the organ transforms the food into Qi and blood, which are further transported to the Lung. Through the dispersing function of the Lung, Qi and blood spread throughout the entire body.
• When food accumulates in the Stomach, the Qi in the Middle-Jiao is blocked. Patients may feel fullness and distension, sometimes with pain in the stomach and abdomen.
• When Stomach-Qi fails to descend, nausea and vomiting may occur.
• Since the Stomach is a Yang Ming organ, it is active in ripening food with its Yang and heat. When the Qi is blocked, heat can over-ripen the food, which leads to foul breath, and patients may vomit undigested food.
• The Large Intestine is a Yang Ming organ; constipation may present when there is dry-heat there.
• In a chronic condition, particularly when the Qi is too weak to ascend to transform the food into essence, dampness may accumulate and phlegm may be formed, which leads to diarrhea.
• When food accumulation is in an acute stage, the color of the tongue is almost normal; however, it will turn dark if the accumulation becomes chronic. The thickness of the tongue coating indicates the degree of accumulation; a yellow tongue coating indicates the degree of heat in the Stomach; sticky indicates the accumulation of dampness and phlegm of the Spleen. As to the pulse, a slippery, forceful and rapid pulse indicates an excess condition of accumulation; a wiry pulse indicates pain and tension in the Middle-Jiao; a thready pulse suggests deficiency.
(See Figure 8.1 on page 232.)
Treatment principle: Promote food digestion, regulate the Qi in the Middle-Jiao and strengthen the Spleen
Herb selection principles and formula composition strategies
• First, herbs that enter the Stomach and Spleen meridians, and have the function of promoting digestion are selected.
• Second, herbs that regulate the Qi movement and water metabolism in the Middle-Jiao, remove dampness and phlegm and thereby enhance the ability of the herbs that promote food digestion are selected.
• Herbs that tonify the Spleen-Qi, clear heat and warm the Spleen are often selected according to treatment need.
Note
• Formulas that treat food accumulation and formulas that drain downwards have similarities in application. Both treat accumulation and they both descend the Qi in the Stomach and intestines.
• Formulas that reduce food accumulation are relatively gentle. The purpose of the treatment is to dissolve the accumulation gradually, and they are used for mild accumulations.
• Formulas that drain downwards can powerfully stimulate the intestines and purge the accumulation. These formulas are strong, and the purpose is to guide out the accumulation vigorously and quickly in a very short time.
CAUTIONS
1. Choose a short treatment course for acute and excess accumulation:
Because formulas that reduce food accumulation can digest and dissolve food and phlegm, they can also injure the Stomach, Spleen, Qi and blood. They are usually only used for a short period of time. When the accumulated food has been digested, these formulas should be stopped.
2. Caution in pregnancy:
Formulas that remove food accumulation should be used with caution during pregnancy as they contain a number of herbs that activate Qi movement to remove food, phlegm and dampness.
3. Pay attention to the condition of the Spleen and Stomach in chronic cases:
Formulas that remove food accumulation are suitable for excess and acute conditions. In a condition of chronic food accumulation, among people who have deficiency of the Spleen and Stomach, a formula with tonifying herbs should be used for a long period of time, together with gentle herbs that promote digestion.
4. Avoid sweet food and herbs:
Sweet food and herbs should be avoided as they can increase the dampness in the Middle-Jiao in a condition of food accumulation. Furthermore, they make the dampness accumulation worse and patients may easily feel nauseous.
5. Follow an appropriate diet:
During treatment, patients should take soft, gentle and warm foods, which are easily digested while being rich in nutrition. After recovery, appropriate dietary advice should be given to patients according to the digestive capacity of each individual.
Structure of the formula and selection of herbs
Chief: Reduce food accumulation and aid the digestion
Mai Ya ( Hordei fructus germinatus), Shen Qu ( Massa medicata fermentata) and Shan Zha ( Crataegi fructus)
These three herbs have the function of promoting digestion. Since they are often used together and are very effective in treating food stagnation, they have another name – Jiao San Xian; Jiao means deep dry-fried, San means three and Xian means immortal. In other words, it means three very effective herbs. These herbs are often deeply dry-fried until their colors change to deep brown, based on the belief that this makes them easier to digest. They work particularly on the Middle-Jiao.
These three herbs are often used together because their different functions can enhance each others’ therapeutic effects. Mai Ya is sweet and neutral, and enters the Spleen and Stomach meridians. It especially aids the digestion of wheat, rice and fruits. Shen Qu is pungent, sweet and warm, and enters the Spleen and Stomach meridians. It particularly aids the digestion of grains and dispels the effects of alcohol. Shan Zha is sour, sweet and slightly warm, and enters the Spleen, Stomach and Liver meridians. It especially aids the digestion of meat, fat and milk. In most cases of food stagnation these kinds of food and drink are all involved, hence these herbs are often used together.
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